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Inspection on 12/07/05 for Orchard House Nursing Home

Also see our care home review for Orchard House Nursing Home for more information

This inspection was carried out on 12th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a comfortable, homely environment with an emphasis on a `home from home` feeling. The home is well maintained and cleaned to a high standard. There is a stable staff group who know their residents well and are able to provide consistent care. A resident said the home was `marvellous`, another said, the `girls are very good, they are very capable and know what they are doing`. Other comments received were, ` the staff are great with lots of friendly banter, lots of laughter and great fun`, `there is nothing I would change, and they are like my own family`.

What has improved since the last inspection?

Since the last inspection a patio has been laid outside the smoking room, furnished with new garden furniture and an awning is being erected. The kitchen is in the process of being refurbished, with the provision of new fridges and freezers.A new call bell system has been installed which staff said had been a great improvement for them enabling them to provide a quicker and more efficient response to residents when they called for assistance.

What the care home could do better:

The home continues, with the leadership of the proprietor, the managers and staff to meet and exceed the minimum standards. They have complied with previous requirements left at the last inspection.

CARE HOMES FOR OLDER PEOPLE Orchard House Nursing Home Grosvenor Road Mablethorpe Lincolnshire LN12 1EL Lead Inspector Jean Cope Unannounced 12 July 2005 09.00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Orchard House Address Grosvenor Road Mablethorpe Lincs LN12 1EL 01507 472203 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Orchard House Nursing Home Ltd Mrs Jean Pemberton Care Home 52 Category(ies) of Old Age (OP) - 46 registration, with number Physical Disability (PD) - 9 of places Terminally Ill (TI) - 1 Dementia over 65 (DE(E)) - 3 Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Within the registration the following placements are allowed: 7 2 1 3 PD aged 40 years and over accomodated in Rooms 1, 2, 3, 8, 9, 47, and 48. PD (Respite only) aged 25 years and over accomodated in Rooms 6 and 16. TI aged 55 years or over. DE(E) aged 60 years and over Date of last inspection 23.0.04 Brief Description of the Service: Orchard House is a large detached residence with a new extension situated in large grounds. The extensive grounds are largely laid to lawn with mature trees and there are pleasant and landscaped seating areas for service users. The home is situated 500 yards from the town centre of Mablethorpe and there is good access to public transport and local community facilities. The home provides nursing and personal care to 52 older people and has nine beds, which may be used for younger adults who have a physical disability. The homes registration also includes 1 bed for a terminally ill service user. Accommodation is provided on ground and first floor levels and there is a passenger lift. There are 44 single and 3 double bedrooms provided, 9 of which are en-suite. There are a variety of lounges, a large dining room and conservatory. The home is appropriately adapted to meet the physical needs of older and disabled people including lifting appliances and assisted bathing. The statement of purpose sates that the home’s aims are to provide an ever improving and caring service within the community that reflects their commitment to treat clients as individuals. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector undertook this unannounced inspection with the assistance of the deputy manager of the home, over four and a half hours. The inspector toured the building, talked with residents living in the home and with staff. The main method of inspection used was called ‘case tracking’ which involved selecting residents and tracking the care that they receive through the checking of their records, discussion with them, the care staff and observation of care practices. The home was fully occupied on the day of the inspection. What the service does well: What has improved since the last inspection? Since the last inspection a patio has been laid outside the smoking room, furnished with new garden furniture and an awning is being erected. The kitchen is in the process of being refurbished, with the provision of new fridges and freezers. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 6 A new call bell system has been installed which staff said had been a great improvement for them enabling them to provide a quicker and more efficient response to residents when they called for assistance. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,3, 4 and 5 Written information is offered to new residents and their families so that they are able to make an informed choice about the home. Residents are assessed and will be assured that the service provided in the home will be able to meet their needs. EVIDENCE: The home has a statement of purpose, which is currently being reviewed by the proprietor to include the improvements made to the home. There is a service user guide available which describes the facilities and services provided in the home. The aims of the home are ‘to provide an ever improving and caring service offering dignity, rights and choice with a positive, contented environment’. The management team assesses new residents prior to them moving into the home wherever possible. If it is not possible, information is gathered from health and social care professionals so that they can be sure that the home will meet the resident’s needs. All residents are offered a trial visit. A resident confirmed that their needs were being met, saying ‘nothing is too much trouble’. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 11 Residents moving into the home can be sure that their health care needs will be attended to. Practices are in place to ensure that residents receive the right medication. EVIDENCE: Each resident has an individual plan of care prepared for them, reviewed on a monthly basis and is kept in their own room. Risk assessments are undertaken where necessary. There was evidence that residents’ health care needs were attended to. Senior carers administer medications for those residents receiving personal care, but trained nurses administer the medication for those residents requiring nursing as well as personal care. A random sample of medication administration records was fully completed and medication had been stored safely. Residents who wish to look after their own medication are encouraged to do so and are provided with lockable drawers for safe storage of their medication. Care staff were able to give a good account of how they care for residents at the end of their lives and explained that the nursing team were ‘very good and taught them about various illnesses’. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 The need and choice of activities for residents to become involved in, is given serious consideration and their independence is promoted. Good quality food is provided in the home with plenty of choice available for residents. EVIDENCE: A part time activities co-ordinator is employed to consult with residents about the activities they would like to be involved in. Activities available include gentle movement to music, bingo and quizzes and a weekly visit from a singer. Residents said that they could visit when they wished and visit their relatives in private. Residents were coming and going as they pleased. The home rotates a nine week menu, which provides a cooked breakfast for the residents who would enjoy one, choice of two midday meals and choice of tea time menu. One resident said how much they were enjoying the homemade soup available twice a week, alongside the cakes that are home baked on a daily basis. A resident said ‘there is a good choice of food, if you don’t like what is on the menu, they will find you something you enjoy.’ Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These outcomes were not inspected. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 23, 24, 25 and 26 Residents live in a well maintained, comfortable and clean home and have the choice of where to spend their time with plenty of communal space for them to choose from. EVIDENCE: The home was decorated, maintained and cleaned to a high standard both inside and outside. The home was comfortable, homely and odour free throughout. There are toilets and bathrooms on both floors in the home with six rooms having their own en suite facilities. There are various aids and adaptations available to assist the more frail residents. Personal items of furniture and belongings were seen in residents’ rooms and they had been placed where residents’ wanted them. There are five communal areas, which include a quiet lounge and a smoking lounge. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 28 Staff in the home are committed to providing good quality care for the residents living in the home and confirmed that they are provided with sufficient equipment to do their jobs. EVIDENCE: The home provides nursing care to some residents, so a qualified nurse is on duty twenty fours a day. There is a nurse in charge with a care team, including a senior carer, and seven care assistants in the morning, with five care assistants in the afternoon. A member of staff said that ‘things usually run smoothly’, with another saying, ‘we are a happy staff team with everyone getting on very well and any equipment we request is provided for us’. A resident said that ‘you ring your call bell and the staff are there almost straight away’. Many frail residents were sitting in one lounge, many of them unable to know how to call for assistance should they need it. A system needs to be put in place to ensure that the staff team checks these residents frequently. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33 and 38 Residents benefit from a home that is well run with a committed, happy staff team. EVIDENCE: It was noted that fire extinguishers had been service in February 2005 and hoists in the home, in January 2005. Fire bells are checked on a weekly basis Staff said that the manager was ‘ a good manager, who listens to you, is supportive and makes it a nice place to work’. A staff member said that ‘we pride ourselves in the care we give, and look after residents in the way that we would want to be looked after. The home has regular residents and relative meetings to request their views on how the service could be improved. Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 3 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 3 x x x x 3 Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 16 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 27 Regulation 13(4) c Requirement Staffing arrangements must be reviewed to ensure that there are regular checks on residents who are sitting in communual areas, who may not be able to call for assistance.. Timescale for action 30.10.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 17 Commission for Social Care Inspection Unity House, The Point Weaver Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Orchard House Nursing Home C53 C04 S61935 Orchard House Nursing Home V238210 120705 Stage 4.doc Version 1.40 Page 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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